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BCBS Texas

I currently live in Maryland and have insurance with my school in Virginia that will run out on February 28th. I will be graduating in February and moving to Texas shortly after which qualifies me for the special enrollment period according to the BCBS Texas representative I chatted with. Thing is, she also informed me that BCBS Texas does not cover bariatric surgery at all for the entire state of Texas but many people here on the forums have successfully had their their surgeries covered by BCBS Texas. I've just turned 26 so the whole insurance thing is all new to me and I'm only looking at BCBS Texas because from what I've read here on the forums, their pre-operation requirements are not as tedious/time-consuming as other insurance companies. With all the conflicting information I'm not sure what to think now and would love any information from you guys in the forums that could help clear things up.

Edited by seizethelook

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I'm in Kansas but have BCBS of Texas. They cover after you jump through the hoops. Policies vary and (from what your rep said) from state-to-state. Would it cover if you went to a neighboring state (assuming that's possible for you)?

  • Author

@@songsmith Hi, thanks for your reply! I think having it in Texas would be the best option for me right now but may look at neighboring states if things don't work out in the future ... Curious to know what you mean by "jump through the hoops" if you don't mind sharing??

My surgery was covered under BCBS Texas (retired from state institution). Although my BMI was 36, I had several obesity related conditions. I got approval in about 10 days. The only issue is the high deductible that must be met before they will pay 100%.

Seizethelook- if you would like to send me a message, I'll be happy to share more details with you. I can give you the the instructions on how to access the BCBS policy for bariatric surgery.

The hoops weren't too bad. I just didn't want to wait that long! I needed to meet with the dietitian for six months before they would approve surgery. Last week was my final meeting. In hind sight, I wish I had used those months to really begin adjusting my eating and exercise routine, but I was at 43 BMI and worried I might lose too much and drop the BMI to an "acceptable" amount. It wasn't until the past few weeks that I really knuckled down.

I have friends who had the surgery, and their insurance company only required 2 months of dietitian visits and a psych eval, so I call BCBS of TX's procedure "hoops." (It really wasn't that bad.)

  • Author

@@songsmith Haha, those are the hoops I thought I would be avoiding by going with BCBS Texas!! Like you said, I worry I'll lose too much weight and fall below the 40 BMI mark. It seems like everyone has a different experience even though it's the same insurance company!!!

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